Provider Demographics
NPI:1184916975
Name:BROWN, PATRICE AMOS (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:PATRICE
Middle Name:AMOS
Last Name:BROWN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 KITTAMA DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3170
Mailing Address - Country:US
Mailing Address - Phone:703-475-3952
Mailing Address - Fax:888-242-8040
Practice Address - Street 1:1400 MERCANTILE LN
Practice Address - Street 2:240
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5341
Practice Address - Country:US
Practice Address - Phone:703-475-3952
Practice Address - Fax:888-242-8040
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05944225X00000X
DCOT010000262225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist